Shifting Paradigms in the Treatment of Systemic Lupus Erythematosus

Authors

  • Ann E. Clarke, MD, MSc, FRCPC Division of Rheumatology, Cumming School of Medicine, University of Calgary
  • Megan R.W. Barber, MD, PhD, FRCPC Division of Rheumatology, Cumming School of Medicine, University of Calgary
  • Bryce Barr, MD, FRCPC Section of Nephrology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba
  • Kim Cheema, MD, FRCPC Division of Nephrology, Cumming School of Medicine, University of Calgary
  • Nicholas L. Li, MD, PhD, FRCPC Division of Nephrology, Cumming School of Medicine, University of Calgary

DOI:

https://doi.org/10.58931/crt.2024.1248

Abstract

For many years, therapeutic options for patients with systemic lupus erythematosus (SLE) have been extremely limited. However, over the past decade, with the approval of new drugs and several promising phase II trials, treatment paradigms are gradually shifting toward multi‑targeted therapies for lupus nephritis (LN) and earlier usage of biologics in extra-renal lupus. Below, we will present three patient cases that illustrate how, through a multidisciplinary clinic environment, we have incorporated these shifting treatment paradigms into our delivery of care. Finally, we will conclude with a discussion of emerging therapies, which have the potential to further shift, and ultimately transform, treatment paradigms.

Author Biographies

Ann E. Clarke, MD, MSc, FRCPC, Division of Rheumatology, Cumming School of Medicine, University of Calgary

Dr. Ann Clarke is a Professor in the Division of Rheumatology at the University of Calgary and holds The Arthritis Society Chair in Rheumatic Diseases. She is the Founder and Director of the University of Calgary Lupus/Antiphospholipid Syndrome (APS) Centre of Excellence. Her research focuses on the risk and determinants of malignancy in SLE, the economic burden of SLE, and clinical trials of novel therapeutics. Dr. Clarke has published over 450 manuscripts and is very engaged in the training of the next generation of lupus clinicians and investigators. 

Megan R.W. Barber, MD, PhD, FRCPC, Division of Rheumatology, Cumming School of Medicine, University of Calgary

Dr. Megan Barber is a rheumatologist and clinician investigator and the Associate Director of Clinical Trials and Clinical Research for the University of Calgary Lupus Centre of Excellence. Particular research interests include antiphospholipid syndrome and novel lupus therapeutics.

Bryce Barr, MD, FRCPC, Section of Nephrology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba

Dr. Bryce Barr is a nephrologist and Assistant Professor in the Department of Medicine at the University of Manitoba. He specializes in glomerulonephritis, with specific interest in lupus nephritis and ANCA-associated vasculitis and is the principal investigator of the Manitoba Glomerular Diseases Registry.

Kim Cheema, MD, FRCPC, Division of Nephrology, Cumming School of Medicine, University of Calgary

Dr. Kim Cheema is a nephrologist in Calgary, Alberta with clinical expertise in glomerular conditions. She completed her internal medicine and nephrology training in Calgary, which was followed by advanced subspecialty training in Lupus and Vasculitis with Professor David Jayne. 

Nicholas L. Li, MD, PhD, FRCPC, Division of Nephrology, Cumming School of Medicine, University of Calgary

Dr. Nicholas Li is a Nephrologist and Clinical Assistant Professor in the Department of Medicine at the University of Calgary. He received his PhD in human immunology from the University of Alberta and his MD from the University of Calgary, where he also completed Internal Medicine and Nephrology. Dr. Li also pursued advanced fellowship training in Lupus, Vasculitis, and Glomerulonephritis at The Ohio State University under the mentorship of Dr. Brad Rovin.

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2024-09-17

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Clarke AE, Barber MR, Barr B, Cheema K, Li icholas L. Shifting Paradigms in the Treatment of Systemic Lupus Erythematosus. Can Rheumatol Today [Internet]. 2024 Sep. 17 [cited 2024 Dec. 21];1(2):4–16. Available from: https://canadianrheumatologytoday.com/article/view/1-2-Clarke_et_al

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